Delivering consistent quality, liposuction results is more difficult than most people realize. Liposuction skills vary more than they do for any other plastic surgical procedure I’ve ever seen. Mastering this procedure takes years of dedication,skill and commitment. Considering how much variation there is in Liposuction skills among plastic surgeons, patients should be extremely cautious when choosing providers. To do this, I suggest patients have multiple in person consultations before scheduling any permanent irreversible of body contouring procedure, such as Liposuction or fat transfer. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Once done liposuction results are fairly permanent and irreversible. Correcting or improving the results of poorly done Liposuction is difficult and patients should keep expectations on the low side. Improving poorly done liposuction results is typically done with revision Liposuction, and or fat transfer. If the primary procedure was done aggressively, then it becomes more difficult to improve the outcome with revision Liposuction. Postoperative massage has no impact on liposuction results. The results are a direct reflection of only two variables. The first is the patient’s candidacy for the procedure in the first place and the second is the skill and experience of the provider. These are the primary two variables that matter when it comes to cosmetic surgical outcomes. Revision Work is many times more difficult than primary liposuction. Considering how much variation there is an Liposuction skills among plastic surgeons, anybody seeking revision work should be extremely selective when choosing providers. Fat transfer, sometimes can improve areas were too much fat was removed, but the procedure tends to be limited and it’s usefulness because areas needing volume are depleted of sufficient host tissue to support grafted fat, making fat grafting unreliable with unpredictable fat survival rates. Improvements can generally always be ahead, but sometimes it might take several procedures, and in the end only modest improvements are generally possible. Liposuction is very much one of those procedures that should be done once and done correctly. If you don’t use the right provider in the first place, it becomes very difficult to end up with the type of results you had hoped for. I cannot emphasize enough the importance of properly vetting plastic surgeons by having multiple in person, consultations before choosing permanent, irreversible body contouring procedures. I recommend patients have in person, consultations and avoid a virtual consultation whenever possible. I also recommend avoiding traveling long distances for elective surgical procedure, if at all possible. The number of plastic surgeons who truly mastered liposuction and fat transfer, are in a small minority. Best, Mats Hagstrom, MD